Purchased Referred Care Clerk
Purchased Referred Care Clerk
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$ 15 - 18
1 Vacancy
Job Description
Closing Date: Monday April 28 2025 @ 4:00 P.M. (MST)
Salary Range: $15.45 $18.24/hour
**APPLICANT MUST HAVE A VALID UNRESTRICTED INSURABLE DRIVERS LICENSE**
**RESUMES AND REFERENCES ARE REQUIRED**
ESSENTIAL DUTIES FUNCTIONS AND RESPONSIBILITIES
- Initiates Purchased/Referred Care (PRC) applications from external providers by obtaining information from patient family members or designated responsible person.
- Initiates PRC applications for FDIHB medical staff nursing and ancillary staff.
- Updates the patients registration database including but not limited to income information third party information and any other information required to meet the eligibility factors of the PRC Program.
- Logs in all PRC applications/notifications by date of service.
- Routes all PRC applications/notifications to Chief Medical Officer (CMO) for medical priority.
- Provides education to patients and providers on the PRC five 5 eligibility factors.
- Issues purchase orders (PO) and/or denials are within specified time limits.
- Follows up with vendor for payment inquiry discrepancies open documents and provides status on all POs.
- Maintains PRC files according to current filing system.
- Assists with submitting and closing out Catastrophic Health Emergent Funds (CHEF) cases to assure reimbursement.
- Assists with Emergent transport requests from inpatient/outpatient departments by contacting ground and/or air medical transportation.
- Assists with received information for emergent transport companies and share information with receiving facility.
- Assists patients and providers with arranging nonemergent transports.
- Maintains transportation log for all medical transports.
- Provides information by telephone and personal inquiries regarding payment outstanding charges eligibility etc.
- Gathers information that are sensitive to PRC cases for eligibility denials appeals to submit to appropriate department.
- Enters all patient referrals into Referral Care Information System (RCIS) and ensures approval or denial is issued to patients and/or vendors.
- Performs other duties as assigned.
MANDATORY MINIMUM QUALIFICATIONS:
Experience:
One 1 year experience in registration scheduling screening or customer service.
Education:
High School Diploma or Equivalency (HSE).
Please email degree or transcripts to
NAVAJO/INDIAN PREFERENCE:
FDIHB and its facilities are located within the Navajo Nation and in accordance with Navajo Nation law has implemented a Navajo/Indian Preference in Employment Policy. Pursuant to this Policy applicants who meet the minimum qualifications for this position and who are enrolled members of the Navajo Nation will be given primary preference in hiring and employment for this position and members of other federally recognized Indian tribes will be given secondary preference. Other candidates will be considered only after all candidates entitled to primary or secondary preference have been fully considered.
Employment Type
Full-Time
